Study at CHOC May Improve Outcome for Preemies

Chad Lieber, Ph.D., director of the CHOC Bio-Optics Laboratory, and CHOC neonatologist John Cleary, M.D., are focusing on one of the greatest challenges facing preemies – nutrition. In studies over the next two years, sponsored by the Gerber Foundation, small optical sensors will be placed on nearly 200 CHOC NICU babies’ foreheads and bellies, to attempt to predict preemies’ tolerance for feeding and ultimately help improve the long-term outcome for these vulnerable babies. Dr. Lieber (pictured above) talks more about this unique study:

Q: What are these optical sensors and what will they measure?A: These are the same sensors that are rapidly becoming standard practice in measuring oxygenation in the brain. They are about the size of a Band-Aid, and emit low levels of light on one end which travels through the tissue before being collected on the other end of the sensor.

Q: What makes this study so unique?A: Since this technique uses light, it is done painlessly and instantaneously. Two very important things for patients, their families, and caregivers. But the technique itself, known as near-infrared spectroscopy or NIRS, has been used for many years to determine brain oxygenation in critical care children and adults.

We are simply moving the sensor from the forehead (where it measures the brain) to the abdomen (where it can measure the bowel). What is truly unique about our study is that our primary goal is to provide reassurance that babies can tolerate food, and secondarily to provide early indication of intolerant digestive systems.

Q: How will this method benefit premature babies and theirfamilies?
A: At this point, we don’t know that it will, in fact, benefit anybody. But some of our preliminary data leads us to believe that it could, and this is why the Gerber Foundation has invested in our study.

In brief, our approach may allow caregivers an accurate assessment of the maturity of babies’ bowels, so they can decide whether to give them food by mouth or via an intravenous (IV) needle, with the main goal of providing optimum nutrition without inducing any injury.

Q: Why is optimal nutrition for preemies so important?A: Particularly in very small preterm babies, the bowel sometimes hasn’t matured enough to be up to the task of handling food. So caregivers are faced with a double-edged sword: (A) give food too early and risk injuring an immature digestive system that may then require surgery to correct, or (B) try to avoid such injury by feeding through an IV and risk suboptimal nutrition that can permanently impair brain development.

These are not one-time choices, but decisions that are made on a continuous basis while the baby is in the unit. Choosing correctly each time is vital to ensuring that babies get the right nutrition to develop properly and without further complication.